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Effects of high-speed rotational atherectomy in peripheral artery disease patients with calcified lesions: a retrospective multicenter registry


Calcified lesions still remain a technical challenge even in the treatment of infrainguinal artery disease. The aim of this retrospective, multicenter observational study was to investigate interventional outcomes of a high-speed rotational atherectomy device (Rotablator™) and to compare clinical outcomes in patients who underwent Rotablator and those who did not even after failed balloon angioplasty because of underlying calcified lesions. This study enrolled patients who underwent Rotablator (Rota group) and those who did not (Non-rota group) between January 2010 and 2014 December at 12 hospitals. A total of 67 limbs and 68 lesions in 65 patients were included (Rota group; 54 limbs and 55 lesions in 52 patients, Non-rota group; 13 limbs and 13 lesions in 13 patients). In the Rota group, a technical success rate was 94.5% with a complication rate of 1.8%, and all lesions underwent subsequent postdilatation following the adjunctive use of Rotablator, and approximately half of above-the-knee lesions underwent stent implantation. The Rota group had a significantly lower clinically driven reintervention rate at 12 months than the Non-rota group (26.5% vs. 58.3%, respectively, p = 0.046). In addition, Rota group showed a trend toward a higher amputation-free survival compared to the Non-rota group at 1 month (Rota; 98.0% vs. Non-rota; 84.6%, respectively, p = 0.10). Rotablator was used as an adjunctive device with a high technical success and a low complication rates, and Patients who underwent Rotablator yielded a significantly lower clinically driven reintervention rate at 12 months compared to those who did not even after failed balloon angioplasty.

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  1. 1.

    Kawarada O, Zen K, Hozawa K, Ayabe S, Huang HL, Choi D, et al. Contemporary critical limb ischemia: Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care. Cardiovasc Interv Ther. 2018;33:297–312.

    CAS  Article  Google Scholar 

  2. 2.

    Tomy M, Kini AS, Sharma SK. Current status of rotational atherectomy. J Am Coll Cardiol Interv. 2014;7:345–53.

    Article  Google Scholar 

  3. 3.

    Fukuda K, Yokoi Y. Application of rotational atherectomy for a calcified superficial femoral artery lesion. Cardiovasc Interv Ther. 2015;30:351–5.

    Article  Google Scholar 

  4. 4.

    Schwarzwälder U, Zeller T. Below-the-knee revascularization. Advanced techniques. J Cardiovasc Surg. 2009;50:627–34.

    Google Scholar 

  5. 5.

    Zacca NM, Raizner AE, Noon GP, Short D 3rd, Weilbaecher D, Gotto A Jr, et al. Treatment of symptomatic peripheral atherosclerotic disease with a rotational atherectomy device. Am J Cardiol. 1989;63:77–80.

    CAS  Article  Google Scholar 

  6. 6.

    White CJ, Ramee SR, Escobar A, Jain S, Collins TJ. High-speed rotational ablation (Rotablator) for unfavorable lesions in peripheral arteries. Cathet Cardiovasc Diagn. 1993;30:115–9.

    CAS  Article  Google Scholar 

  7. 7.

    Dorros G, Iyer S, Zaitoun R, Lewin R, Cooley R, Olson K. Acute angiographic and clinical outcome of high speed percutaneous rotational atherectomy (Rotablator). Cathet Cardiovasc Diagn. 1991;22:157–66.

    CAS  Article  Google Scholar 

  8. 8.

    The Collaborative Rotablator Atherectomy Group (CRAG). Peripheral atherectomy with the rotablator: a multicenter report. J Vasc Surg. 1994;19:509–15.

    Article  Google Scholar 

  9. 9.

    Henry M, Amor M, Ethevenot G, Henry I, Allaoui M. Percutaneous peripheral atherectomy using the rotablator: a single-center experience. J Endovasc Surg. 1995;2:51–66.

    CAS  Article  Google Scholar 

  10. 10.

    Myers KA, Denton MJ. Infrainguinal atherectomy using the Auth Rotablator: patency rates and clinical success for 36 procedures. J Endovasc Surg. 1995;2:67–73.

    CAS  Article  Google Scholar 

  11. 11.

    Mahmud E, Keramati S, Salami A, Palakodeti V, Tsimikas S. Expanded applications of rotational atherectomy in contemporary coronary and peripheral interventional practice. J Invasive Cardiol. 2005;17:207–10.

    PubMed  Google Scholar 

  12. 12.

    Schwarzwälder U, Zeller T. Debulking procedures: potential device specific indications. Tech Vasc Interv Radiol. 2010;13:43–53.

    Article  Google Scholar 

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This study was partially supported by Endovascular Asia, a nonprofit physician education and research meeting.

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Correspondence to Osami Kawarada.

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Osami Kawarada reports honorarium of lectures and advisory board fees from Boston Scientific Corporation.

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Yamamoto, Y., Kawarada, O., Ando, H. et al. Effects of high-speed rotational atherectomy in peripheral artery disease patients with calcified lesions: a retrospective multicenter registry. Cardiovasc Interv and Ther 35, 393–397 (2020).

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  • Rotablator
  • Peripheral artery disease
  • Calcification